Adler cites cost problems in rejecting health bill

Rep. John Adler (D., N.J.) broke from most of his party in the U.S. House to vote against the massive overhaul of the nation's health system, saying the legislation would fail to flatten the ever-rising cost of care.

Adler, narrowly elected last year to represent South Jersey's competitive Third District and a potential Republican target in 2010, was one of 39 Democrats who voted against the bill late Saturday.

"Individuals and small businesses and taxpayers already can't afford these spiraling health costs," Adler said yesterday. "We've got to figure out a way to slow that growth."

The House passed its health package by a slim margin, 220-215, handing a victory to President Obama and Speaker Nancy Pelosi (D., Calif.). But the road ahead is uncertain.

The Senate, where conservative Democrats have more power, is considering less expansive versions of health-care legislation. Whatever passes there must be reconciled with the House bill.

All but eight of the dissenting House Democrats represent districts carried by Republican John S. McCain in last year's presidential election. Obama won Adler's district with 52 percent of the vote. Adler was the first Democrat in more than a century to win the district, which includes Burlington and Ocean Counties and Cherry Hill in Camden County.

Democratic Gov. Corzine lost last week in an election that exit polls showed was heavily influenced by unaffiliated voters who shifted Republican. But Adler has criticized various drafts of the House bill as lacking cost-containment measures since at least June. He said that it would be wrong to "read anything" about public opinions of health-care legislation into Corzine's loss.

"I think the New Jersey election was primarily about Jon Corzine," Adler said, noting that every Democrat in the Assembly who sought reelection won last Tuesday.

In Pennsylvania, two Democrats representing conservative-leaning districts - Reps. Jason Altmire of Allegheny County and Tim Holden of Schuylkill County - also bucked the party to vote against the legislation.

Altmire, a former health-care executive, said that he voted against the bill because it did not control costs or remove inefficiencies in the system.

Holden told reporters yesterday that the bill did not contain strong enough language to stop undocumented immigrants from receiving government-paid health care, and that it also would cut payments to Medicare and Medicaid providers too much.

Besides, Holden said, the House bill could not pass in the Senate, and he did not want to be a political "pawn."

Adler said there were any number of proposals for reining in costs that those who drafted the House bill elected not to include. Among them, he said, were establishing an independent commission to control reimbursement rates for Medicare, use of electronic medical records, more vigorous efforts to reduce "defensive medicine" by providers worried about lawsuits, and reducing health insurance premiums for people who control their blood pressure, weight, and cholesterol.

He said that the employer mandate to provide insurance should be indexed to inflation. The bill would exempt businesses with payrolls of less than $500,000 a year from having to provide insurance to employees, but if that threshhold were not allowed to rise with inflation, an increasing number of small businesses would be burdened, Adler said.

"All the conversations I had with leadership and the White House were policy-driven, respectful and statesmanlike in tone, but there did not seem to be a willingness to involve cost containment," Adler said. "I could never get a good explanation for why we couldn't do it in this bill. It's frustrating."

He said, "My fear is future Congresses won't make the hard decisions."

U.S. Rep. Robert E. Andrews, a Camden County Democrat who represents the First District, was among the authors of the House version. He said the bill does address health-care costs, but added that there was room for improvement as the legislative process continues.

"John has raised some very valid concerns, and many of us are looking for ways to make the bill even more cost-effective," Andrews said. "I don't think any member is ever wrong for voting his conscience."